title: Neonatal seizures: soothing a burning topic.
abstract: Neonatal seizures are a potentially life-threatening pediatric problem with a variety of causes, such as birth trauma, asphyxia, congenital anomalies, metabolic disturbances, infections, and drug withdrawal or intoxication. Thorough and timely evaluations of such patients are necessary to identify and treat the underlying etiology, therefore reducing potential morbidity and mortality. We review neonatal seizures and hypocalcemia and present the case of a 6-day-old male infant who presented to a tertiary pediatric emergency department with seizure-like episodes. He was found to have markedly low serum calcium, magnesium, and parathyroid hormone concentrations, as well as a significantly elevated serum phosphate concentration. The etiology of these abnormalities was found to be maternal ingestion of extremely high doses of calcium carbonate during the third trimester of her pregnancy, an occurrence that has been reported only once in the literature. Education pertaining to the dangers of excessive calcium carbonate intake during pregnancy may be an important piece of anticipatory guidance for pregnant mothers with symptoms of gastroesophageal reflux, and questioning the mother of a neonate presenting with seizures about such over-the-counter medications may help to elucidate the diagnosis.
authors.affiliation: From the Department of Pediatrics, Section of Emergency Medicine, Yale University School of Medicine, New Haven, CT.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Thornton
authors.forename: Lei
authors.initials: L
authors.lastname: Chen
authors.forename: Melissa L
authors.initials: ML
authors.lastname: Langhan
mesh_terms: D000863:Antacids / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use; D001787:Blood Group Incompatibility; D002119:Calcium Carbonate / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use; D016640:Diabetes, Gestational / Q000188:drug therapy; D003937:Diagnosis, Differential; D004630:Emergencies; D005260:Female; D005764:Gastroesophageal Reflux / Q000188:drug therapy*; D006801:Humans; D051556:Hyperbilirubinemia, Neonatal / Q000209:etiology; D006996:Hypocalcemia / Q000150:complications / Q000151:congenital*; D007003:Hypoglycemia / Q000151:congenital / Q000209:etiology; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000493:pharmacokinetics / Q000627:therapeutic use; D007011:Hypoparathyroidism / Q000151:congenital / Q000209:etiology; D007231:Infant, Newborn; D008274:Magnesium / Q000097:blood; D008297:Male; D008431:Maternal-Fetal Exchange; D010281:Parathyroid Hormone / Q000097:blood; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy*; D011263:Pregnancy Trimester, Third; D011297:Prenatal Exposure Delayed Effects; D012640:Seizures / Q000097:blood / Q000209:etiology*
chemical_list: D000863:Antacids; D007004:Hypoglycemic Agents; D010281:Parathyroid Hormone; D002119:Calcium Carbonate; D008274:Magnesium